Cholesterol Meds
TX
Lifestyle changes (diet, fish oil, omega 3 FA, ↑ PA)
To ↓ LDL - Statin
Add ezetimibe if statin hasn't worked
To ↑ HDL - Niacin
To ↓ Triglycerides - Fibrates
AIM FOR
Low LDL (< 100); DM (< 70)
High HDL (> 40)
Triglycerides (< 150)
Total (< 200)
Statin Intensity
High Intensity
↓LDL > 50%
Atorvastatin 40-80 mg
Rosuvastatin 20-40 mg
Moderate Intensity
↓ LDL 30-49%
Lovastatin 40-80 mg
Pravastatin 40-80 mg
Simvastatin 20-40 mg
Atorvastatin 10-20 mg
Rosuvastatin 5-10 mg
Low Intensity
↓ LDL < 30%
Pravastatin 10-20mg
Lovastatin 20mg
Simvastatin 10 mg
Statins
Statins recommended to take at bed-time, especially simvastatin (shortest T1/2)
Night time is when most cholesterol synthesis occurs
Lovastatin should be taken with meals
Pravastatin & Rosuvastatin are more hydrophilic (may ↓ chance of rhabdo and cognitive ∆)